The Center for Medicare and Medicaid Innovation will soon launch “new, bold” models for value-based care — and they might be mandatory, according HHS Secretary Alex Azar’s remarks at a Sept. 6 meeting in Washington, D.C., for the Physician-Focused Payment Model Technical Advisory Committee.

Despite the growth in coordinated care and value-based pay, alternative payment models have produced lackluster results so far, Mr. Azar said, citing a CMS report that found ACOs have not delivered significant savings after taking all costs and incentives into account.

“Without real accountability, we’re just offering bonuses on top of payments that may be too high already. That’s why we have now proposed to simplify the ACO system into two tracks, requiring them to take on risk sooner,” Mr. Azar said. Among ACOs, the best results have been driven by both those in two-sided risk tracks and physician-led models. On Aug. 9, the agency proposed a new rule that would overhaul the Medicare Shared Savings Program and push ACOs into two-sided risk sooner.